JEREMY MICHAEL WAGONER LCSW
NPI 1982093522
Social Worker - Clinical in Bowling Green, KY

Q: What is Jeremy Wagoner's NPI number?

The NPI number for Jeremy Wagoner is 1982093522. It was assigned to this individual provider in the NPPES registry on January 20, 2015.

Q: What is Jeremy Wagoner's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Jeremy Wagoner was last updated on January 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 20, 2015

1300 ANDREA ST, SUITE 205, BOWLING GREEN, KY 42104(270) 904-2260(270) 781-9680 Get Directions Write a Review

NPPES record last updated: January 20, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jeremy Michael Wagoner Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMY MICHAEL WAGONER LCSW (NPI 1982093522) is an individual clinical provider in Bowling Green, Kentucky, licensed in Kentucky (3958) and active in the NPI registry since January 2015.

NPPES Registry Identity

NPI1982093522

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameJEREMY MICHAEL WAGONERCredential: LCSW

Location Address1300 ANDREA ST, SUITE 205Bowling Green, KY 42104-3382

Mailing Address1300 Andrea St, Suite 205Bowling Green, KY 42104-3382 · (270) 904-2260 · Fax (270) 781-9680

Phone(270) 904-2260

Fax(270) 781-9680

Sole ProprietorYes

Enumeration DateJanuary 20, 2015

✔ NPI 1982093522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in KY · 3958

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

1300 ANDREA ST, Bowling Green, KY 42104

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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VERDANT HEALTHCARE LLC

Clinic/Center (Primary Care)

1300 ANDREA ST, SUITE 100
BOWLING GREEN, KY 42104

Warren County (270) 780-3546

BOWLING GREEN PEDIATRICS, INCORPORATED

Pediatrics